ESPN 51th Annual Meeting

ESPN 2018

1- MARMARA UNIVERSITY MEDICAL SCHOOL DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- MARMARA UNIVERSITY MEDICAL SCHOOL DEPARTMENT OF NEONATOLOGY

Introduction:

Acute kidney injury(AKI) is a serious condition that affects 8% to 24% of hospitalized neonates and it is associated with mortality rates of 30% to 40%. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit(NICU) of MarmaraUniversity Hospital

Material and methods:

This is a clinical, retrospective study that was performed in a NICU at the Marmara University Hospital in Istanbul. All neonates(≤28 day old) hospitalized from January 2010 to December 2017 with documented AKI were included.

Results:

During the study period 3392 newborn infants were hospitalized in the NICU and 92(2.7%) infants developed AKI. Fifty-six(61%) patients were male and 36(39%) were female. Most of the neonates were preterm(66%) and in 61 preterm neonates 19 were late-preterm(31%). Oliguric/anuric AKI was found in 39 cases(42%) and non-oliguric in 53 cases(58%). The prevalence of prerenal, renal and post renal AKI were 39%, 60% and 1% respectively. Perinatal asphyxia was the most common predisposing factor for AKI and was evaluated in 31%. The other mostly detected predisposing factors were prematurity with/without respiratory distress syndrome in 26%, sepsis in 13%, and congenital heart disease in 3%. In 31(28%) of the newborns there was more than one co-morbid cause. Acute peritoneal dialysis were performed for 6 patients(6.5%) and continuous venovenous hemodiafiltration for one patient with congenital heart disease. While the mortality rate of our unit ranged from 2.55% to 6.86 in 2011-2017, the mortality rate of newborns complicated with AKI was found to be 29%.

Conclusions:

AKI in the newborn is a common problem and has multifactorial etiology. It is a life threatening condition with still high mortality rate. Early recognition of the risk factors and the rapid effective treatment of the predisposing co-morbid factors may help to reduce the incidence of AKI in the neonatal period.